How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,122 to $11,749Professionalmedian $646 · 10th to 90th $490 to $1,047
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $10,471.29 | Facility | None | $645.65 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,000.00 | Professional | None | $645.65 | $645.65 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,370.32 Typical High $10,232.93 | Facility | None | $1,174.90 | $5,370.32 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,348.96 | Professional | None | $602.56 | $707.95 | $1,348.96 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $9,120.11 Typical High $27,542.29 | Facility | None | $5,128.61 | $9,120.11 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,071.52 | Professional | None | $660.69 | $707.95 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $891.25 | Professional | None | $457.09 | $575.44 | $891.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where New Jersey sits
The same service costs 6.8 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $13,753MT $2,023
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.